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How common is back pain in Al-Qaseem region.

OBJECTIVE: The aim of this study was to estimate the prevalence of back pain in the adult population of Al-Qaseem Central Province, Kingdom of Saudi Arabia and to find associated features and factors. METHODS: A house-to-house survey covering 1,000 household in the towns and villages of Al-Qaseem province was carried out over a period of 18 months extending from September 1993 until the end of February 1995. A total of 5,894 adults, aged 16 years and above, were questioned by trained staff regarding back pain, and the demographic data in addition to general, medical and social history. RESULTS: A response was obtained in 5,743 (97.4%). Their mean age was 34.14 15.16 (range 16-99). Back pain was reported by 1,081 (18.8%), wherein 499 (8.8%) were men, and 574 (10%) were women. Back pain was more prevalent in married (23.3%) individuals than unmarried (6.4%). Adjusted odds ratio (OR) for back pain in married individuals was 1.88 (95% confidence intervals [CI] 1.49-2.37). Back pain was strongly correlated with age (correlation coefficient = 0.378 P < 0.01). It also showed significant correlation with weight and height, depression, family history of back pain, change in work ability, frequency of attendance at local doctor, use of medication and lower education level. The association with body mass index became evident only after comparing the heaviest 20th percentile to the lightest (OR 1.335 [95% CI, 1.279-1.402]). Certain occupational status (unemployed, farmers, professional workers and housewives) were associated with back pain. CONCLUSION: Back pain was relatively common in this largely unindustrialized community although its prevalence is lower than reported from some western countries.

Adolescent↗

Oral health disparities between ranks in a military environment: Israel Defense Force as a model.

UNLABELLED: Some studies have demonstrated a relationship between occupational status and position in the workplace to use of dental services and oral health status. Ranks symbolize social status in the military hierarchy, which is different from that accepted in civilian workplace. OBJECTIVE: This study was aimed at analyzing differences between officers and noncommissioned personnel in regard to dental treatment needs and use of dental services. METHODS: One-thousand, one-hundred thirty-nine personnel of the Israel Defense Force were examined, using DMFT (decayed, missing, filled permanent teeth and CPITN (community periodontal index of treatment needs indices to define oral health status. A questionnaire was used to calculate utilization rates. RESULTS: Noncommissioned personnel had on average 50% more unmet caries treatment needs, and 19.1% of them suffered from deep periodontal pockets. No differences were demonstrated in utilization rates CONCLUSIONS: Military rank influences oral treatment needs the way civilian organizational structure does with the exception of utilization rates of dental services.

Adult↗

[The effects of hormone replacement therapy in menopause on symptoms of anxiety and depression].

OBJECTIVE: Replacement of deficient hormones (hormone replacement therapy, HRT) is the main treatment modality in menopause. There is no concensus among researchers as to how HRT influences psychiatric symptoms that might develop during menopausal period. In this study we aimed to explore the effects of HRT on symptoms of anxiety and depression comparatively by using either estrogen or tibolone. METHOD: Women with natural menopause who applied to the outpatient Clinic of Obstetrics and Gynecology Department were included in the study. Subjects (n=70) were randomized into two groups with one group to receive 17beta-estradiol and other group tibolon. All subjects were evaluated at baseline and after 3-months of HRT with Hamilton Anxiety Rating Scale (HARS) and Hamilton Depression Rating Scale (HDRS). RESULTS: Forty six of 70 patients completed the study. The 17beta-estradiol (n=23) and the tibolone (n=23) groups were similar with respect to age, education and occupational status. The time from onset of menopause was longer in the tibolon group. HARS and HDRS scores were significantly decreased after 3 months of HRT in both the 17beta-estradiol and the tibolone groups. The two drug regimens were not significantly different in this respect. CONCLUSION: HRT with 17beta-estradiol and tibolone improves symptoms of anxiety and depression in menopausal women.

Anxiety↗

Epidemiological features of suicides in Osijek County, Croatia, from 1986 to 2000.

Suicide is a devastating tragedy associated with social, cultural and psychological factors. It takes approximately 1,060 lives in the Republic of Croatia each year. We retrospectively reviewed all cases referred to in the Registrar office and Police Department at Osijek County from 1986 to 2000. The cases of suicide totaled 1,017. All of the cases were analyzed as to age, gender, marital status, occupation, place and time of suicide and method of suicide. The suicide rate for the entire population of the County averaged 20.5/100,000 inhabitants per annum. The age of the suicides ranged from 15 to 92. The male to female ratio was 2.1:1. The highest suicide incidence was among the age groups from 55 to 64 (19.27%), followed by age group from 45 to 54 (16.12%). The lowest suicide incidence was among the age group < 19 (3.4%). The incidence in the group 85 > years was also low (2.06%). The suicide was frequent among people who live alone: single, widowed, divorced (47.29%). Eighty percent of victims were found in surroundings familiar to them. These included various premises of their residences. The retired, the laborers and the unemployed (67.36%) were predominant among suicide victims. The most common methods of suicide were hanging (43%), followed by firearms (24%). No correlation was found with the day of the week or the month of the year. The study showed a slightly increased rate of suicide, from 21 cases at the beginning of the investigation (in 1986) to 22.3/100,000 population fifteen years later (in 2000).

Adolescent↗

Enterobiasis in primary schools in Bang Khun Thian District, Bangkok, Thailand.

A study of enterobiasis and its correlation with various factors that could potentially influence the rate of infection was conducted among 3,621 primary school children (five to ten years old), drawn from sixteen schools in Bang Khun Thian District, Bangkok. Diagnosis was by the transparent tape swab technique, which was used to recover Enterobius vermicularis eggs from the perianal region. The transparent tape swabs were then placed on slides for examination by light microscopy. The average rate of infection for the group was 21.57%. No statistically significant differences were found between the male and female children. The younger children had a higher rate of infection. Subjects from schools located in industrial and metropolitan areas showed slightly higher rates of infection than those from agricultural areas. Data from the questionnaires in the study indicated that factors such as parental socio-economic status (occupational, income and education) and the children's personal hygiene contributed to the varying rates of infection.

Child↗

Understanding women's attitudes towards wife beating in Zimbabwe.

OBJECTIVE: To investigate the factors associated with attitudes towards wife beating among women in partnerships in Zimbabwe in order to assist public health practitioners in preventing intimate partner violence (IPV). METHODS: A nationally representative survey of 5907 women of reproductive age (15-49 years) was conducted in Zimbabwe. Women were asked about their attitudes towards wife beating in five situations. The survey included sociodemographic characteristics, partnership characteristics, and household decision-making. FINDINGS: Over half of all women in Zimbabwe (53%) believed that wife beating was justified in at least one of the five situations. Respondents were most likely to find wife beating justified if a wife argued with her spouse (36%), neglected her children (33%), or went out without telling her spouse (30%). Among women in partnerships (n=3077), younger age, living in rural areas, lower household wealth, schooling at a lower level than secondary, and lower occupational status were associated with women reporting that wife beating is justified. Women who reported that they make household decisions jointly with their partners were less likely to say that wife beating is justified. CONCLUSIONS: Zimbabwe has a long way to go in preventing IPV, particularly because the younger generation of women is significantly more likely to believe that wife beating is justified compared with older women. Given the current social and political climate in Zimbabwe, finding means to negotiate rather than settle conflict through violence is essential from the household level to the national level.

Adolescent↗

Tooth cleaning methods and their effectiveness among adults in rural Tanzania.

This study was undertaken to investigate how various population characteristics affect the choice of different tooth cleaning methods and to estimate their role in preventing occurrence of plaque, calculus and gingivitis among rural adults in Tanzania. Two hundred adults aged 20 years and over were interviewed and clinically examined for plaque, calculus and gingival bleeding. A high proportion (97.5%) of the subjects reported that they clean their teeth every day. Among them, 69.4% used only indigenous tooth cleaning methods, 16.3% only factory made toothbrushes and 14.3% both. Twigs (Chewing sticks) were the most commonly used indigenous tooth cleaning method, followed by charcoal. Together with age, educational and occupational status and tribal origin significantly affected the choice of tooth cleaning method. Men had more often visible plaque than women (OR = 2.84). However, other sociodemographic factors and the method of cleaning teeth were not significantly associated with the occurrence of plaque, calculus or gingival bleeding.

Adult↗

[Social differences in infant mortality in a longitudinal Turin study].

The Turin longitudinal study enables to study the one-year survival of children born to any member of the study population and to relate the still-born and infant mortality to the parents' census characteristics. In this paper 25,108 children, born between 1981 and 1985 of parents residents in Turin at the 1981 population census, were followed up with respect to one-year survival. The numbers of infant deaths have been observed according to parents' education, housing ownership, occupational status and professional position. Only parents' education showed consistent differential in the still-born and infant mortality risks, adjusted for maternal age.

Confidence Intervals↗

Diarrhoeal diseases amongst children under five. A study in rural Alwar.

A house to house survey was done in three villages of district Alwar covering 875 children under five years age. Two week incidence of diarrhoea morbidity was 2.27 episodes/child/year taking into consideration the seasonal correction factor. The incidence decreased with increase of age. Incidence was found significantly more in children of illiterate mother (p < 0.05). Children of poor socio-economic conditions as determined by occupational status (labourers) suffered significantly more often from diarrhoea as compared to children of higher socio-economic status (agriculturist and others). Fifty per cent episodes of diarrhoea were treated with antibiotics, and only one child was given ORS. It is a matter of concern. About 3.7 per cent mothers washed their hands before preparing meals while, 1.6 per cent washed their hands after toilet. Only 2 per cent mothers had the knowledge of preparing the home made salt sugar solution. An intensive health education campaign is therefore, necessary for health professionals as well as mothers.

Child, Preschool↗

Spirometric studies of the subjects in an active area of Hyderabad A.P.

Study area is the "All India Industrial Exhibition", Hyderabad in the heart of the Hi-tech city with 2000 stalls/pavilions. It is visited by nearly 20 lakh people every year in 45 days of exhibition. Persons actively involved in All India Industrial Exhibition are selected for the spirometric studies. Selected subjects were administered the ATS Questionnaire. Data pertaining to age sex status, occupation, general health, family background for allergy, asthma, lung cancer, etc. Their lung efficiency is spirometrically studied. They were also administered 2.5 mg Salbutamol. People complaining about cough, sputum, wheeze, running nose/stuffy nose, sneeze, dyspnoea were categorized as suffering from sinusitis, rhinitis and chronic bronchitis. People from Salbutamol reversibility of airflow obstruction were diagnosed as asthmatics. Analysis of variance, multiple comparison test, student-t-test and normal curve test were used for statistical analysis. Present study reveals a direct relation between polluted air and respiratory morbidity.

Adolescent↗

Neuropsychological sequelae of hard metal disease.

To evaluate the memory complaints of a group of patients with hard metal disease, 12 adult, former tungsten carbide workers with hard metal disease and 26 healthy, unexposed control subjects matched for age, race, sex, occupational status and education were administered the Wechsler Memory Scale-Revised (WMS-R), the Peterson Word Triad Test, Squire's Current Events Test (including both the recall and recognition forms), and Squire's Television Title Recognition Test. The exposed group demonstrated deficits in short-term verbal memory, allocation of central processing resources, and remote verbal memory compared to the control group. Visual memory was spared. Comparisons were made to previous investigations of memory functioning within the toxicology literature.

Journal Article↗

A survey of common misconceptions about head injury and recovery.

A survey questionnaire composed of 25 statements about head injury and recovery was administered to 221 individuals at a large regional shopping mall. Survey items were categorized into domains pertaining to the use of seatbelts, the nature of unconsciousness, the nature of amnesia, characteristics associated with brain injury, and recovery from brain injury. An additional 8 survey items inquired about the sources from which people obtained their knowledge, extent of personal experience with brain injury, occupational status, educational status, residential status, and their use of seatbelts. Results indicate substantial levels of misconception about the nature of unconsciousness, amnesia, and recovery, but surprisingly few misconceptions about seatbelts and the effects of brain damage. These findings corroborate clinical observations of gross misconceptions reported in the literature. Specific misconceptions appeared with comparable frequencies across the age groups studied, which indicates that family education for patients in rehabilitation needs to target all members of a family, rather than a designated primary caregiver.

Journal Article↗

[Relationships between insight and medication adherence in subjects with psychosis].

BACKGROUND: Poor medication adherence in subjects with psychosis has a high prevalence and a negative impact on clinical outcome. Several studies have reported that a poor level of insight was a strong predictor of poor medi-cation adherence. However, few studies have investigated whether insight was associated with medication adherence, independently from other clinical and treatment characteristics. OBJECTIVE: To explore the link between insight and medi-cation adherence in subjects with psychosis, and to assess the impact of potential confounding factors on this association. METHOD: Subjects included in the study were patients aged 60 or less, consecutively admitted in a psychiatric ward, and presenting with at least one psychotic symptom (delusion or hallucination). Medication adherence was assessed using: 1) history of total discontinuation of treatment against medical advice over the 2 weeks before admission; 2) the 7-point rating scale developed by Kemp et al.; 3) the self-report questionnaire Drug Attitude Inventory (DAI). The Scale to assess Unawareness of Mental Disorder (SUMD) was used to measure level of insight. Assessment of symptoms was performed using the Scale for the Assessment of Positive Symptoms (SAPS), the Scale for the Assessment of Negative Symptoms (SANS), and the Calgary Depression Scale (CDS). DSM IV diagnoses were assessed using the Diagnostic Interview for Psychosis (DIP). The associations between level of insight (SUMD scores) and the three measures of medication adherence were explored using the non-parametric Mann-Whitney and Spearman's tests. Logistic regression models giving Odds Ratios (ORs) and 95% confidence intervals (95% CI) were used to examine the impact of potential confounding variables on the associations between level of insight and medication adherence. RESULTS: 42 patients presenting with schizophrenia broadly defined (n=25) or psychotic mood disorder (n=17) were assessed. Significant associations were found between higher SUMD scores (ie poorer insight) and discontinuation of treatment before admission (z=- 2.6, p=0.009), poor medication adherence rated using the Kemp et al.'s scale (r=- 0.64; p=0.0001), and negative perception of treatment assessed using the DAI (r=- 0.405; p=0.009). The Kemp'scale score and the DAI score were categorised into poor vs. good according to the median for logistic regression analyses. Subjects were 1.7 times more likely (OR=1.7, 95% CI 1.1-2.5, p=0.01) to have discontinued their treatment, 1.9 times more likely (OR=1.9, 95% CI 1.3-2.8), p=0.0003) to have poor medication adherence rated with the Kemp's scale, and 1.8 times (OR=1.8, 95% CI 1.2-2.6, p=0.005) more likely to have a negative perception of the treatment for one point increase at the SUMD score (ie lower level of insight). The associations between SUMD score and the three measures of medication adherence were not modified after adjustment for demographic characteristics (age, gender, educational level, occupational status, marital status) and categorical diagnosis (schizophrenia broadly defined vs. psychotic mood disorder), severity of symptoms (SANS, SAPS, CDS scores), characteristics of the psychotropic treatment, diagnosis of substance or alcohol use disorder, age at onset, and number of previous admissions. CONCLUSION: The study demonstrates that medication adherence is associated with the level of insight, independently from other patient's demographic and clinical characteristics. The association between low level of insight and poor medication adherence should be confirmed using prospective studies carried out in ambulatory patients. These findings suggest that psycho-educational programs aimed at improving insight should be developed in order to improve medication adherence.

Adult↗

Cancer mortality among Polish migrants to France.

Cancer risk in the Polish-born population of France has been compared to that in Poland and in native French subjects (born in France), using mortality data from the period 1979-1985. The Polish-born community in France is a long-established one--most migration occurred during the 1920s--so that for many cancer sites the cancer pattern is closer to that of French natives than that in Poland (eg oral cavity, oesophagus, large bowel, gall bladder, uterus, leukaemia). Polish migrants, however, retain their characteristically high rates of cancer of the stomach and lung (in men), and low rates of breast and prostate cancer. The Polish-born community has a characteristic pattern of residence (living mainly in the Nord and the Pas-de-Calais) and occupational status (a higher proportion of 'workers' than the French-born); these are important confounding factors which can mask the true differences in risk for several sites (larynx, oesophagus, large bowel) if no adjustment is made during analysis.

Adolescent↗

AIDS-related opportunistic infections in Hospital Kuala Lumpur.

We retrospectively reviewed 419 HIV/AIDS patients in Hospital Kuala Lumpur from 1994 to 2001. In the male group, the age range was 20-74, with a mean age 37 years, while in the female group it was 17-63, with a mean age of 33 years. With regard to age group, it was found that the preponderant age group was 25-34 years. The majority of male subjects were Chinese (52.5%), single (56.3%), and unemployed (55.1%), whereas the females were Malay (42.3%), married (79.5%), and non-laborer (64.1%). Also, both groups resided in Kuala Lumpur and had heterosexual contact as the leading cause of HIV transmission. More than half of the patients had CD4 cell counts of <200 cells/cumm. We found that the acquisition of HIV infection via intravenous drug use (IDU) was directly related to the incidence of tuberculosis infection (P < 0.05). Further analysis showed HIV-related tuberculosis with IDU was also dependently correlated with occupational status (unemployed) (P < 0.05). The four main AIDS-defining diseases include tuberculosis (48%), Pneumocystis carinii pneumonia (13%), toxoplasmic encephalitis (11%), and cryptococcal meningitis (7%); in addition, 53% of these patients were found to have CD4 cell counts of less than 200 cells/cumm at the time of diagnosis.

AIDS-Related Opportunistic Infections↗

[Patient rehabilitation following cystectomy for cancer].

In 171 out of 251 cancer patients subjected to cystectomy, the bladder was replaced for isolated intestinal segment followed by recovery of transurethral urination. This recovery produced a favorable effect on physical, psychological and social, occupational status of the patients. Two-stage technique of establishing reservoir for the urine with renewal of transurethral urination is detailed. Normalization of the function of the kidneys and upper urinary tracts, prevention or early treatment of complications, natural transurethral urination should be considered criteria for rehabilitation of postcystectomy cancer patients.

Adult↗

A survey on oral hygiene practices among Malaysian adults.

A survey on oral hygiene practices was conducted on 537 dentate adult patients aged 15 years and over. The aim of this study was to investigate the variation in dental behavior with regards to socio-demographic factors, namely age, sex, ethnicity, income, education and occupational status. Patients attending nine randomly selected government dental clinics were interviewed on their daily oral hygiene practices. The majority (89.7%) of the subjects reported that they brushed their teeth, 68% used toothpaste containing fluoride, but only 8.4% flossed their teeth. Generally the younger group had better oral hygiene habits. The higher the socioeconomic status of the adults, the better their toothcleaning practices. Awareness concerning dental floss was low regardless of all the socio-demographic variables. It was concluded that there is a need to improve the dental health practices of adults in Malaysia.

Adolescent↗